New approaches to the delivery of health care to adolescents. Adolescents are a new population group showing certain common characteristics which transcend the confines of geography, economics, education, culture and race. Certain health problems have emerged which are closely related to the life style of teenagers. These health needs are not met by existing health care delivery systems, and future planning must take into account the morals of young people. At present there is no unified approach to the development of health care programs for adolescents, but important explorations of effective methods are are taking place in a fragmentary way. The challenge is to provide the necessary technology and professional expertise in an accessible setting and then to weld these services into programs which will become cohensive and stable. Analyses of data show that adolescents seek help more often for primary and preventive care than for serious ilnesses. Services are particulary needed for addictive problems, emotional disorders, suicidal states, and conditions related to  sexual activity. Consideration of the effect of adolescent behavior on the reproductive cycle is of the utmost importance. These sequelae of conception and veneral disease can be extremely serious for the immature girl and her baby. Therefore the opportunity for birth control, health education, abortion and prenatal care for teenagers should be priority goals in any program for adolescents. The provision of services for the young mother and her baby should be included in the overall plan. New approaches in the ambulatory care of adolescents include an age-specific operation, satellite clinics with hospital backup, and the inclusion of young people in the planning services. Care should be comprehensive and continuous, and a multi-disciplinary staff team would permit a more effective approach. The involvement of other teenagers as assistants in counseling has been found an effective method of communication; this relaitonship may bridge the generation gap when highly personal experiences must come to the surface. Financial and legal barriers should be removed so that care is available to all. Social systems which affect the adolescent should coordinate their activities at all levels. Examples of some innovative methods are available. The ideal approach to health care delivery for adolescents is not yet established; but it must obviously do more than merely cope with a series of crisis oriented episodes. A recognition of underground self-help methods is needed, even if in the last analysis these methods are found to be irrelevant and are discarded. The health of teenagers automatically and immediately affects the well being of the following generation. No effort to improve the situation should be spared.


Proceedings: The development of sexuality in adolescence.


Proceedings: The development of the menstrual pattern.


Proceedings: The contraceptive dilemma in adolescents. The birth control pill versus the intrauterine device.


The occurrence of isolated dysplastic, carcinoma in situ, and invasive type cells in cervical smears from patients with invasive squamous cell carcinoma: significance to prescreening using image processing techniques.


The adolescent with a learning problem. Experience and insight with delinquent boys. Twelve teenaged boys referred by a juvenile court clinic because of delinquent behavior and academic failure were examined by an experienced team of pediatricians, neurologists, psychologists, social workers, nurses, and occupational, physical, recreational, speech and hearing therapists. Two boys came from troubled families with long histories of legal problems, had behavior problems antedating their school difficulties and had no evidence of perceptual handicaps. The remaining ten were the family blacksheep whose academic problems began early and whose behavior decompensated later. They all had perceptual handicaps and both groups of boys had intense psychological reactions to their school difficulties. The learning disabled require a flexible team approach in school together with individual, group and family therapy in order to achieve success.


Provision of maternity and prenatal care to adolescent girls.


Proceedings: Specific reading and writing difficulties in preadolescents who have received treatment at a child psychiatric hospital.


Proceedings: Jejunoileal bypass by morbidly obese adolescent.


Proceedings: Follow-up study on patients treated in an out-patient adolescent clinic.


Proceedings: The rehabilitation of disabled adolescents.


Proceedings: Persepectives on adolescent medicine: concepts and program design. The concepts and goals of a program in adolescent medicine should include development of a capability to focus on current health needs of youth in a variety of settings; to plan clinical services to meet those needs with the flexibility necessary to respond to changing future requirements; and to deliver service within such a context while simulataneously creating a milieu conducive to education and investigation into the very process and definition of adolescence. The Division of Adolescent Medicine at Montefiore Hospital and Medical Center was designed 7 years ago to fulfill these goals and consequently may serve others as a functional model for health care delivery to teenagers. The Division is comprised of: (1) a 37 bed in-patient unit; (2) a hospital-based ambulatory program including general diagnostic and follow-up services, as well as a speciality service capability in the areas of gynecology and family planning, cardiology, gastroenterology and nutrition; (3) primary care health services within teenage dentention and prison facilities; (4) addictive disease diagnostic and treatment programs; (5) school health programs from intermediate school through college levels, and (6) the division also performs supportive and consultative functions for a variety of community-based agencies. Within the programatic design approximately 70,000 adolescents have been served. The cornerstone of the educational and investigative efforts has been the concept that all the above six functional units are clinical laboratories and classrooms so that training and research activities are integral parts of each of the service areas. This program design is continually undergoing revision and refinement so as to remain ever-responsive to new and emerging problems to meet additional training demands and, most importantly, to permit and encourage creativity and growth patients and staff.


Prospects for reindeer husbandry based on grass and silage feeding.


The president's message.

The president's message.


The epidemiology of trichostrongylid infections in young cattle in Norway.


Achievement award 1976: the Robert Wood Johnson Foundation.


Peer Review: threat & opportunity.

Peer Review: threat & opportunity.


First impressions: a rubber stamp of your personality.


Working together for our future.

Working together for our future.


Too little - too late?

Too little - too late?


Letter: Pseudo-Chediak-Higashi anomaly in acute leukemia.


Management of hallucinogen abuse.

Management of hallucinogen abuse. Most street hallucinogens contain either LSD or phenycyclidine HCl (PCP). Because the acute phase of LSD and PCP mimic several other drugs and conditions, it is important to exclude these other possibilities. When faced with LSD or PCP, "talking down" usually suffices for the mild case; management becomes more complex should hyperpyrexia, coma, seizures or a hypertensive crisis ensue. Diazepam, not a phenothiazine, is preferred for sedation.


Letter: Vasculitis as a complication of high-dose methotrexate in the treatment of acute leukemia.


The child with leukemia: in a special hematology clinic.


The child with leukemia: the disease and its treatment.


Immune markers in adult acute leukemia.

Immune markers in adult acute leukemia. Three cases of adult acute leukemia were examined for immunologic markers. Incubation of leukemic cells with anti-D (IgG)-coated erythrocytes was used for the identification of monocytes; sheep erythrocytes were employed for T-cells and fluorescein-conjugated anti-mixed immunoglobulins for B-cells. It was shown that IgG receptors (monocytes) were present on immature cells with predominant monocytic components; T- and B-cell markers were absent in the mono- and myelocytic leukemias.


Evaluation of the Lung Ventilator Performance Analyser. The characteristics of the Lung Ventilator Performance Analyser (LVPA) have been compared with the model lung defined in the proposed ISO standard for Breathing Machines. The different characteristics of the two models lead to marked differences in the pressure, flow and volume curves obtained during a standard procedure. The LVPA is a useful teaching tool, but it is recommended that ventilator testing should be performed on a lung model which fulfills the requirements of the proposed International Standard.


A disconnection alarm for the Bennett BA-4 ventilator. A simple warning device is described to attach to a Bennett BA-4 Ventilator. It has proved reliable in practice when the ventilator is operated on pressure limit.


Emergency drills for the anesthetic team.


Intra-arterial injection of a barbiturate--a case report.


Editorial: Thickening vapors.

Editorial: Thickening vapors.


Solubility of injectable Valium in plasma and saline.


The role of suggestion in conscious-sedation.


The doctor-patient relationship in an intravenous-sedation practice.


The president's corner. Nitrous oxide--effects on the patient and dentist.


Anesthesia monitoring of the ambulatory patient.


Outpatient intravenous sedation for a dental patient with narcotics addiction--report of a case.


The president's corner. The ADSA--who do we represent?


An inhalation analgesia circuit to minimize nitrous oxide pollution.


Editorial: Thickening vapors--II.

Editorial: Thickening vapors--II.


Malaria complicating neoplastic disease. Two patients with neoplastic disease had transfusion-induced malaria. In a patient with acute myelogenous leukemia infected with Plasmodium vivax, neither his underlying disease nor intensive cytotoxic chemotherapy appeared to ameliorate or worsen the clinical course of his infection. In a splenectomized patient with metastatic carcinoma of the colon, P malariae infection was associated with a fulminant course simulating cerebral malaria. Despite delay in diagnosis, both patients responded dramatically to antimalarial chemotherapy and both developed appreciable antibody responses.


Partial deletion of long arm of chromosome 17: a specific abnormality in acute promyelocytic leukemia? Two patients with acute promyelocytic leukemia had an identical chromosomal abnormality detected by fluoresecence banding. In each case, the clinical course was rapidly fatal, and was characterized by a lack of response to chemotherapy with cytarabine and thioguanine, and was complicated by disseminated intravascular coagulation. Bone marrow cells from each patient contained 46 chromosomes; in each instance, however, one chromosome 17 had a deletion of almost one half of the proximal portion of the long arm [del(17)(q11q21 or 22)].


An unusual complication of nasal-tracheal anesthesia.


Short-term effects of preganglionic sympathectomy on the structure of submandibular salivary acinar cells in rats.


Bone-imaging and semiconductor probe measurements of technetium-99m-polyphosphate in the detection of periapical pathology in the dog.


Distribution of incisor caries in 11- and 12-year old English children.


Inhibition of calcium phosphate precipitation by human salivary secretions.


. . . In the eyes of the editor.

. . . In the eyes of the editor.


A quantitative study of alpha-aminoacylpeptide hydrolase activity in the human dental pulp.


Conditioning-effect of vibratory stimulation on dimension discrimination of objects held between human tooth arches.


Isolation of bacteriophages specific for the genus Veillonella.


"Doctor, is this your patient"?

"Doctor, is this your patient"?


Effects of occlusal instability.

Effects of occlusal instability. Changes that may occur in an occlusion are basically either horizontal or vertical. Horizontal changes need not be damaging and may be readily accommodated. Vertical changes can be more damaging and require a more extensive treatment procedure.


Research into mastication.

Research into mastication. An electronic method of recording displacement was used to study mandibular movement during mastication. The technique enables the parameters of muscle activity, the sound of tooth contact, the force developed between opposing teeth, and the displacement of the mandible to be recorded at the same time on a single U/V chart. Previous reports on mandibular movement using cine-photographic techniques were confirmed in relation to mastication, but additional information was obtained in relation to muscle activity in the final closing movements. It appears that tooth contact initiates a latent-silent period in masseter and temporalis which occurs before movement is arrested in the final intercuspal position. It is considered that the kinetic energy of the mandible on closing is reduced by the cessation of activity in these two muscles during the silent period and finally absorbed by the crushing of food during the terminal intercuspal slide to rest. A description of mastication is given and a theory advanced that this may be controlled by a central clock mechanism.


President's page. Frustration or opportunity?


A dental viewpoint of drug interactions.


Vasoactivity of local anaesthetic solutions. The basic mechanisms responsible for effects of vasoconstrictors in local anaesthetic solutions are not fully understood. In this paper the interactions of the various ingredients of local anesthetic solutions are considered. Some of the author's work in this field is summarised and current research is discussed.


Role of plaque in dental caries.

Role of plaque in dental caries.


Cryosurgery.

Cryosurgery. Cryosurgery offers a means of destroying tissue by subjecting it to extreme cold. The mechanisms by which cells die are as yet poorly understood, but reliable and predictable clinical results have been obtained in the treatment of a wide range of benign and premalignant oral lesions. Its effectiveness in the primary treatment of malignant oral lesion has not been adequately assessed but at least it offers palliation and relief of intractable pain where conventional cancer therapy has failed. The use of carbon dioxide 'snow' has been tested and found to be a simple and effective means of treating superficial benign lesions of the mouth.


Coming of age.

Coming of age.


The Australian dental standards laboratory.


The department of dental medicine and surgery University of Melbourne.


The present imperfect and future indefinate of dental education.


Oral biology- a philosophical enigma in dental education.


Undergraduate dental education in Queensland.


Dental education and the delivery of dental care.


Editorial: Dentistry at the crossroads.

Editorial: Dentistry at the crossroads.


Salicylate therapy and drug interaction in rheumatoid arthritis. Salicylates form the basis of drug treatment in rheumatoid arthritis. Despite their use for many decades, there is considerable confusion about what constitutes a regime which will ensure anti-inflammatory properties. We have found that blood vessels in the proposed therapeutic range can be maintained overnight on a four times daily dose regime, using either soluble aspirin (in the form of "Disprin") or aloxiprin ("Palaprin Forte"), and on a 12 hourly regine using an aspirin-sustained release aspirin combination ("BiPrin"). Because of variation in the levels reached using a fixed dosage schedule, treatment should be individualised. No correlation was found between dosage levels and either disease activity or serum albumin levels. No significant alteration in free or total salicylate levels was found following the addition of indomethacin to therapy.


Serum gestrin in Chinese patients with peptic ulcer. Fasting serum gastrin was determined in 30 Chinese patients with duodenal ulcer, 43 Chinese patients with gastric ulcer, 23 Chinese control subjects, 14 European control subjects and ten Indian control subjects. Basal and pentagastrin-stimulated peak acid outputs were also determined in the Chinses patients with duodenal or gastric ulceration. The mean (+/- SD) basal serum gastric level for Chinese controls and Chinese patients with duodenal and gastric ulcer were 24-6 pg/ml (+/- 13.7 pg/ml), 18-5 pg/ml (+/- 8-9 pg/ml), and 33-9 pg/ml (+/- 27-7 pg/ml), respectively. Statistical analysis showed no significant difference between the Chinese control subjects and the Chinese patients with duodenal or gastric ulcer, but the mean fasting serum gastrin level of Chinese gastric ulcer patients was significantly higher than that of Chinese duodenal ulcer patients. Comparison of the mean fasting serum gastrin level of the Chinese, European, and Indian control subjects showed no significant difference. Statistical analysis also showed no significant correlation between fasting serum gastrin level and both basal and peak acid outputs, in Chinese patients with duodenal or gastric ulcer.


Medico-dental dilemmas.

Medico-dental dilemmas. Patients with a variety of diseases in the oro-facial region are frequently confused when trying to decide from which of the professions of medicine and dentistry to seek treatment. Furthermore, during the process of arriving at a diagnosis, numerous practitioners and specialists in both professions may be called in for consultation, thus adding to the dilemma. Four cases are reported in this article to illustrate the problem, and some conclusions are drawn as to how it may be minimized albeit not completely solved.


What is tertiary hyperparathyroidism?

What is tertiary hyperparathyroidism? Five patients who had gross abnormalities of calcium and phosphorus metabolism due to long standing renal failure are described to illustrate the difficulties with the term "tertiary hyperparathyroidism". One patient who had unequivocal biochemical tertiary hyperparathyroidism was found histologically to have nodular hyperplasia of all four glands even though one gland weighed twice as much (12g) as the combined weight of the other three. Another patient was not hypercalcaemic but had all the other features of the condition including rapid onset of osteitis fibrosa, vascular calcification and a probable parathyroid adenoma, with hyperplasia of the three glands. The other three had hypercalcaemia only after a reduction in the plasma inorganic phosphorus due either to renal transplantation or aluminum hydroxide therapy. The bone histology of the five patients varied from severe osteomalacia to severe osteitis fibrosa. A consideration of the factors involved in causing hypercalcaemia in these patients and a review of the literature leads to the conclusion that the term tertiary hyperparathyroidism is often misleading and best avoided.


Rapid correction of water intoxication by hypertonic saline and frusemide. A case of profound hyponatraemia with severe cerebral dysfunction, induced by excess water intake and exacerbated by smoking, is described. Rapid correction with hypertonic saline infusions and frusemide allowed a negative fluid balance and elevation of serum sodium concentration to be achieved without precipitating acute pulmonary oedema.


Paget's disease in identical twins.

Paget's disease in identical twins. Paget's disease of bone was found in each of elderly monozygotic twin sisters. Apart from the skull, which was affected in each twin, different bones were involved by Paget's disease. This is the fifth pair of identical twins reported with Paget's disease of bone.


Gastric glycoproteins in chronic peptic ulcer. The output and concentration of gastric glycoproteins in gastric juice from patients with chronic duodenal and gastric ulcer and from controls, have been determined in the basal state and following pentagastrin stimulation. Patients with gastric ulcer had a significantly higher basal glycoprotein output, basal glycoprotein concentration and stimulated glycoprotein concentration than patients with duodenal ulcer or controls. The basal and stimulated glycoprotein output in gastric juice from patients with duodenal ulcer and controls was independent of ABO blood group and secretor status. The carbohydrate composition of the gastric glycoproteins has also been determined in the basal state, and following stimulation of gastric juice by pentagastrin, which did not influence the carbohydrate composition of the molecules. The principal carbohydrate components were galactose, N-acetylglucosamine, fucose, N-acetylgalactosamine, and sialic acid. Small amounts of mannose and glucose were detected in some gastric glycoprotein samples. The carbohydrate composition of the glycoproteins varied according to the ABO blood group and secretor status of the individual. Glycoproteins form stimulated gastric juice from non-secretors of groups A and O had a higher sialic acid content than glycoproteins from secretors of the same blood groups. There were no significant differences in the carbohydrate composition of glycoproteins from patients with chronic gastric and duodenal ulcer compared with gastric glycoproteins from control subjects of the same blood group and secretor status.


Diagnostic and therapeutic approach to chronic leukaemia.


Gastric mucus.

Gastric mucus.


Editorial: Medical research in Australia.


The problem of intrahepatic cholestasis.


The use of high calcium dialysate in the treatment of renal osteomalacia. Four chronic haemodialysis patients suffering from osteomalacia were treated by increasing their dialysate calcium concentration from 1-40 to 2-15 mM/I. Bone biopsies were taken before and after 22 weeks of this treatment and a further biopsy was taken in one patient after 52 weeks. Symptomatic cure occurred in one patient with mild osteomalacia and some improvement osteomalacia and hyperparathyroidism. Bone biopsies showed slight improvement in the patient with mild osteomalacia after 22 weeks, and considerable improvement after 25 weeks. In the patient with mixed histology, the osteitis fibrosa subsided and the osteomalacia became a little worse after 22 weeks. There was no histologic improvement in the two patients with  severe osteomalacia after 22 weeks. It is concluded that high calcium dialysis is not an effective treatment for renal osteomalacia.


Regional differences in lactate concentration in experimental myocardial infarction. Lacate concentrations were measured in blood from (a) coronary veins within ischaemic myocardium and (b) veins nearer to the coronary vein, for periods of up to 2 1/2 hours after ligation of the left anterior descending artery in dogs. Concentrations at (a) were three to four times higher than at (b), while blood sampled simultaneously from two veins at (a) yielded similar concentrations of lactate. At 2 1/2 hours after ligation the veno-arterial difference of lactate concentration in blood from (a) was about one half of the difference at 15 minutes. Lactate concentration at (a) was approximately twice as great when the area of ischaemic myocardium drained by the vein was large (18 not equal to 1% of heart weight) than when it was small (6 not equal to 1% of heart weight). No close correlation was apparent between the height of epicardial ST-segment elevation and the level of lactate release. These experiments extend previous observations that changes in lactate concentration at a given site may reflect changes in venous dilution, rather than in the rate of production of lactate, and emphasize that caution is necessary in interpretation of changes in concentrations of metabolites in coronary sinus blood after acute myocardial infarction in man.


Diazoxide-induced renin release in diagnosis of remediable renovascular hypertension. In hypertensive patients with unilateral renal artery stenosis, intravenous diazoide increased renal vein renin activity more on the involved side than on the contralateral side, whereas, in a group with predominantly unilateral renal parenchymal disease, the increase in renal vein was similar for both kidneys. In patients with bilateral renal artery stenosis, the use of diazoxide was helpful in lateralizing the dominant ischaemic lesion. Diazoide administration appears to be a safe, rapid and convenient method of increasing the sensitivity of the renal vein renin test used in predicting the outcome of surgical treatment of renovascular hypertension. Bilateral renal vein renin determination of established value in the diagnosis of functional renal ischaemia. 1-4 However, in the use of this procedure to predict the efficacy of corrective surgery, false positive and false negative results still occur. Thus, various manoeuvres which stimulate renin release have been employed to  improve the sensitivity of the test. 5-7 We report a new application the practical approach to of this procedure in the diagnosis of renal hypertension, which both basal and stimulated levels of renal venous renin activitity can be measured during a brief period of bilateral renal vein catherization.


The significance of chest pain occurring with the Master two step test. This study has assessed whether chest pain occurring during or after a step test could improve the accuracy of exercise testing in the diagnosis of coronary artery disease (CAD). One hundred and fifty-three consecutive men underwent the double Master two-step test prior to diagnostic coronary arteriography. On hundred and twenty-five had CAD, 28 insignificant disease (NCA). The post-exercise ECG showed at least 0-5 mm of ischaemic ST depression in 71 (57%) of the men with CAD and in five (18%) with NCA. Ischaemic ST depression of at least 2-0 mm occurred in 24 men, all of whom had CAD. Chest pain occurred during or after the test in 78 (62%) men with CAD and in nine (33%) with NCA. The accuracy of diagnosis of CAD could be improved by combining the occurrence of chest pain in the test with a positive post-exercise ECG. Either a 2 mm positive post-exercise ECG with or without test angina or 0-5 mm to 1-9 mm positive post-exercise ECG with test angina was found in 56 (45%) of men with CAD and one (4%) with NCA. Thus the concurrence of chest pain during or after a double Master two-step test, together with ischaemic ST segment depression after the test, strongly suggests the presence of CAD.


Haemolysis in liver disease: relationship to erythrocyte membrane function, serum bilirubin concentration and plasma electrolyte disturbances. The pathogenesis of the mild to moderate haemolysis that is almost universal in patients with liver disease was investigated to determine if it was related to dysfunction of the red blood cell (RBC) membrane resulting from abnormalities in plasma electrolyte, urea or bilirubin concentrations. Thirty-nine patients with various forms of liver disease were investigated as well as six with miscellaneous diseases associated with plasma electrolyte disturbance. RBC membrane permeability was measured by the rate of 22Na influx. The results showed that the shortened RBC survival in liver disease is not related to morphological changes in the RBC or altered membrane integrity as measured by osmotic fragility, mechanical fragility, autohaemolysis, membrane ATP and membrane permeability.


Hereditary thrombocytopathy: a familial bleeding disorder due to impaired platelet coagulant activity. A family with a bleeding disorder due to congenital thrombocytopenic thrombocytopathy is described, with ten affected members in three generations. The disorder is inherited as an autosomal dominant trait and is characterized by thrombocytopenia, morphologically abnormal platelets, prolonged bleeding time, platelet coagulant activity deficiency and abnormal platelets, prolonged bleeding time, platelet coagulant activity deficiency and abnormal platelet aggregation. Patients' platelets adhered to collagen, but aggregation was reversible and the release of platelet constituents was minimal. Aggregation with ADP was similarly reversible, but the platelet response to thrombin was normal. These defects in platelet aggregation and release were not corrected by addition of normal plasma indicating an intrinsic abnormality of platelets. By definition thrombocytopathy consists of a deficiency in platelet coagulant activity. It was shown that the deficiency of platelet coagulant activity caused a delay and decrease in the conversion of prothrombin to thrombin, and it is proposed that the lack of thrombin accounts for the defective release reaction and the reversible aggregation. An adequate haemostatic plug due to decreased release of ADP, together with instability of the plug provide an explanation for the bleeding tendency in thrombocytopathy.


Evaluation of an enteric coated aspirin preparation. The bioavailability and gastrointestinal site of release of enteric coated aspirin tablets ("Rhusal", G.P. Laboratories) were investigated following dosage with single tablets. A delay of one to more than eight hours was observed between dosage and the appearance of salicylate in plasma or saliva. This delay was decreased by pretreatment with metoclopramide. No aspirin or salicylate was detected in gastric aspirates. The mean urinary recovery of salicylate was equivalent to 92% of the administered dose. All these tests were consistent with the designed function of the enteric coating. The time course of concentrations of salicylate in saliva rather than in plasma was confirmed as a useful technique for the evaluation of different formulations of aspirin. The acceleration of gastric emptying by metoclopramide is a useful technique for the evaluation of enteric coated tablets.


Arthur E. Mills Memorial Oration: maintenance of stenosis in internal medicine. Comment.


Cardiovascular complications due to pheniramine overdosage. Cardiovascular toxicity including ventricular extrasystoles associated with pheniramine overdosage has been documented in the absence of factors recognised to aggravate this toxicity. The presence of pheniramine and the absence of other compounds was established using analytical techniques. It is concluded that patients with pheniramine overdosage should be treated exercising the same precautions as with tricyclic overdosage. Several sudden and unexpected deaths have occurred due to pheniramine overdosage in both adults and children. The cause of death in each case was not known. The purpose of this report is to document clinical features of pheniramine overdosage, in particular previously unsuspected cardiovascular toxicity manifesting as clinically significant ventricular arrhythmias. Pheniramine was positively identified in the overdosed patient, and the presence of other agents excluded.


Spirometric values for normal Perth children aged six to twelve years. The purpose of this study was to construct tables and nomograms of spirometric norms for Perth children aged between six and 12 years. These norms were to be based on anthropometric measurements and age. A sample of 623 children was tested of which 556 were analysed and comprised 289 boys and 267 girls. All testing was carried out in the child's own school. The spirograms were recorded with a dry spirometer from which the FVC, FEV1, and FMF were measured. Correlation coefficients were established between each of these ventilatory parameters and anthropometric measurements of height, mass, arm span and age. The findings of the study revealed high correlations for both boys and girls between ventilatory parameters of FVC and FEV1 and height, mass, arm span and age. Moderately high correlations were found for both sexes between FMF and height, mass, arm  span and age. Height correlated best with each of these ventilatory measures. It was also established that significant improvement in some correlations was obtained when anthropometric values were used in multiple correlation analysis. The use of height plus mass proved to be best when predicting FVC and FEV, for boys and girls, and for predicting FMF of girls. FMF for boys could be best predicted by using height alone. The limits of normality for ventilatory parameters of FVC, FEV1 and FMF were found to be best defined by the per cent standard error of the estimate. Tables and nomograms were established from regression and multiple regression equations in order to predict normal values in children. The findings of this study revealed that little difference existed between the ventilatory values of children tested in Perth, Europe and the Eastern States of Australia. However, the differences that were found to exist could be due to the age group which was sampled or possible environmental and genetic differences.


Recurrent ventricular tachycardia in hypothyroidism. Ventricular tachycardia associated with myxoedema is rare. Only two cases have so far been documented. In the report by Hansen, the patient had recurrent chest pain which suggested coexisting coronary heart disease. In the second case, the patient developed recurrent ventricular tachycardia only after intravenous triiodothyronine was given. This paper reports a further case of hypothyroidism with recurrent episodes of ventricular tachycardia and ventricular fibrillation which was not associated with any of the established causes of this arrhythmia.


Detection of hepatitis b surface antigen in patients with acute viral hepatitis. The relative value of solid phase radioimmunoassay and counter immunoelectrophoresis for the detection of hepatitis B surface antigen in the serum, was studied in 1401 patients with acute viral hepatitis. When specimens were obtained early in the illness, counter immunoelectrophoresis was found to be a reliable test for the diagnosis of hepatitis B, detecting 95.6% of patients found to be antigen positive by radioimmunoassay. The additional sensitivity of radioimmunoassay was of particular value for detecting antigen later in the illness and in patients with post-transfusion hepatitis in which the titre was frequently below the level detectable by counter immunoelectrophoresis. Radioimmunoassay was also of value in testing sera which had been stored for many years, detecting up to 3-3 times as many patients with hepatitis B as did counter immunoelectrophoresis.


Maintenance of standards in internal medicine.


Gangrene following intra-arterial injection of procaine penicillin. Irreversible ischaemic gangrene of the upper limb developed in a one-year-old child after an unintentional intra-arterial injection of procaine penicillin. The hand needed amputation. Arterial embolization phenomenon along with intense vasospasm appears to have been responsible for this rare complication. Unintentional intra-arterial injection of penicillin intended for intra-muscular use may lead to disastrous consequences. Regional tissue necrosis has been described previously but ischaemia leading to gangrene of an extremity has not been reported. The following is a case report of a child who developed such a gangrene in his hand which had to be amputated.


Efficacy of the Dalkon shield in contraception.


The pathogenesis of alcoholic hepatitis and cirrhosis.


Neuroendocrine identification of depressed patients. Recent studies of hypothalamo--pituitary--adrenal (HPA) suppression in depressed patients indicate that these subjects often show abnormal early escape of plasma cortisol levels following an initial suppression. Non-depressed psychiatric inpatients usually show normal sustained HPA suppression. The responses of 49 depressed and 30 non-depressed patients have been analysed to develop criteria which can make the dexamethasone suppression test suitable for outpatient studies. The cortisol levels measured in a 24-hour urine collection and a single blood sample post-dexamethasone were sufficient to enable 61% of the depressed patients to be identified correctly at a confidence level of 90%, on the basis of at least one abnormal cortisol value. When both cortisol values were abnormal 35% of the depressed patient were identified correctly at a confidence level of 100%. Patients with "endogenous" depressive profiles had the most abnormal results. A normal response to this test will not necessarily exclude the diagnosis of primary depressive illness. An abnormal response to the test may be of help in confirming the diagnosis. With the simplified procedure outpatient studies may become possible.


The great debate.

The great debate. A.R. Jensen's hypothesis concerning genetically-determined differences in intelligence between North American blacks and whites is summarised. Problems involved in the application of heritability statistics to IQ data are discussed. The concept of "intelligence" is reviewed from a cross-cultural perspective, and an alternative model of potential, competence and performance is proposed. Finally, the questions of scientific freedom and social responsibility are touched upon, and the implications of the great debate for scientists and educators discussed.


Good death: responsible choice in a changing society. Revolutionary advances in social and medical knowledge and technology have radically changed the conditions which precede death for an increasing number of people. The fear of death is being replaced by the dread of too-prolonged life, a feature of which is a widely documented incidence of both pain and physical and mental distress. This situation has produced the accelerating social demand for euthanasia (a painless inducement of death, preferably by medical means) to be legally available to a suffering person earnestly desiring it. The attitudes of medical workers are ambivalent, trapped as they are between a changing society and intransigent law. Psychiatry, however, and its concern for the whole person, is potentially an ally of those who desire to educate the community to a healthier view of death, even a planned death, as a part of life and a responsible conclusion to it.


A scale to measure the stress of life events. A comprehensive life event inventory suitable for questionaire or interviewer administration has been constructed. Two sets of matched scalings of these life events have been derived from the responses of an Australian urban population. Each of the scalings were consistent across the sociodemographic groups in the population. The two scales allow the significance of life events to be scaled in conceptually different ways. The first follows Holmes concept of the extent of life change produced by the event, the second the Paykel concept of the amount of distress caused by the event. The inventory and the scalings are suitable for use in an Australian urban population.


Lithium neurotoxicity.

Lithium neurotoxicity. One of the most alarming and potentially serious complications of Lithium Carbonate therapy is the emergence of central nervous system toxicity. This paper discusses the clinical changes that may occur with illustrative case histories. The role that such factors as serum Lithium levels, sodium balance, organic brain damage, clinical typology, concurrent physical illness and drug interaction play in the genesis of this disorder is discussed. Permanent neurological damage following Lithium poisoning is discussed and guidelines for appropriate use and monitoring of Lithium in psychiatric disorders is outlined.


Concepts of mental illness amongst the rural Xhosa people in South Africa. The rural Xhosa people of South Africa have retained social cohesion through traditional custom, purity of language and the dominant role of ancestor worship, traditional medicine and witchcraft in life-style, beliefs and ceremonies. Abstract concepts are limited and ego defence mechanisms include projection, displacement and rationalization but cognitive disturbances per se are not regarded as important. Major attention is paid to severe conative and affective disturbances, ascribed to object or spirit intrument by a traditional "witchdoctor". Therapy is community orientated as far as possible unless uncontrollable violent behaviour necessitates referral to a mental hospital.


Jealousy as a symptom of psychiatric disorder.


Rating scales as predictors of response to tricyclic antidepressants. Fifty-three patients suffering from depressive illness were classified as 'responders' or 'non-responders' on the basis of an "amelioration score" of the Hamilton Rating Scale for depression after six weeks treatment with nortriptyline hydrochloride at 150 mgs. daily. A multivariate analysis of variance was performed on the four psychological rating scale scores used, to determine whether rating scales could predict treatment response to tricyclis antidepressants was found to be at 75% probability.ic anti-depressants was found to be at 757. probability.ic antidepressants. There was a significant difference between the two groups after adjustment for age. Subjects were then classified as 'non-responders' and 'responders' on the basis of their discriminant scores. The prediction of response to tricycl


An evaluation of evidence on depressive classification and some alternative suggestions from physiology. The wealth of material on depressive classification provides both researcher and clinician with a sorting task of monumental proportions. Moreover the criticisms which have been fired at studies of depressive classification using symptoms as a data base, also require systematic sorting and elucidation. An attempt has been made to review the major studies of depressive classification in a systematic way, together with the principal criticisms which have been made of them. The survey is not exhaustive but aims at providing a relatively ordered overview of the area. The most critical issue, that of subjectivity of data collection is taken up, and it is suggested that biological measures may form a more objective data base for studies of depressive classification than ratings of symptoms and behaviour.


Letter: Attempted suicide.

Letter: Attempted suicide.


Letter: Medico-legal aspects of automatism.


Taboo and Malay tradition.

Taboo and Malay tradition. According to Malinowski there are no peoples, however primitive, without religion and magic; nor are there any societies lacking either in the scientific attitude or in science (Blumberg 1963). Magic and taboo are resorted to when through the normal use of science, or rational techniques, man is unable to control unpredictable events important to him. Where there is difficulty in predicting the outcome of behaviour, where the results of action are not consonant with effort, where there are great limitions on man's knowledge of vital issues, magical techniques are employed--in short, where circumstances of life are uncertain, uncontrolled and unknown. Magic and animism are systems of thought which give not only the explanation of a single phenomenon, but make it possible to comprehend the totality of the world from one point, as a continuity. Of the three systems of thought--animistic, religious and scientific--animism is perhaps the most consistent and the most exhaustive, the one which explains the world in its entirety.


The measurement of plasma levels of tricyclic antidepressant drugs. A double-isotope derivative dilution procedure for measuring plasma levels of Nortriptyline is described. The assay is specific, sensitive, precise and reproducible. Studies on the variation in steady-state plasma levels are described on a fixed oral dosage of nortriptyline. Between individual variations in steady-state plasma levels are large. Between day within individual variation is 15-20%. Dosage regime, time of blood sampling after last oral dose and the method of blood handling are unlikely to affect the steady-state plasma levels. Within an individual, the oral dose, duration of treatment and concomitant drug treatment are all important determinants of the steady-state plasma level.


An attempt to understand Japanese personality from a family psychiatry point of view.


Mental hygiene in diminishing population areas.


What difference does anthropological knowledge make to mental health.


Psychotherapeutic management of a potential spirit medium. Psychotherapeutic management of a potential spirit medium (shaman) in a modern University Hospital setting in Malaysia is described. Magical thinking, projection and spirit possession (trance state) occur during management. Discussion of management was based on what Heinz Wolff described as the psychotherapist's functions of (1) psychodynamic understanding; (2) the therapeutic function; and (3) the developmental function. This patient did not conform to the general criteria of a suitable patient for psychotherapy. But her willingness to engage in therapy contributed to a satisfactory outcome. The therapist's growth in cross-cultural therapeutic encounter seems to be prominent.


Meth-drinkers and lotus-eaters: some educational aspects of transcultural psychiatry in Papua New Guinea. The rapid development of Third-World societies in the Pacific Region, as elsewhere, involves modern, traditional and idiosyncratic factors. Often this complex of interaction is expressed or symbolically exemplified in aberrant behaviors. The paper presents some examples from Papua New Guinea, including methyl-alcohol poisoning amongst students and cargo cults, as part of an interface between traditional and modern. Such aberrant and psychotic behaviors provide a datum for curricula and clinical services. Psychiatric efforts via related disciplines such as anthropology, can provide dramatic pan-human insights into development for contemporary educational and health-delivery services, ultimately with more meaning for recipients, practitioners and research.


Associative illness among aboriginals.

Associative illness among aboriginals. Associative mental illness occurring in close relatives is described from Numbulwar and Yirrkala Missions, two Aboriginal communities in Eastern Arnhem Land. Since it is a clear example of the influence of culture on mental illness, these factors which facilitate the production of the illnesses are examined. They are (1) cross-identification between members of the clan group; (2) the assumption that mental illness is caused by sorcery which acts to detriment of all the relatives in a clan group, not only on the individual; (3) the belief that mental experiences in general are not private and may be shared by close relatives.


Psychiatry in Bali.

Psychiatry in Bali. Since the advent of modern psychiatry to Bali in 1968, great strides have been achieved, but based on the above field study it is found that a large part of the mentally disturbed still rely upon traditional psychiatry, a fact which sould be kept in mind when planning future mental health activities.


The attribution of mental illness by rural Balinese. This paper is based on the answers of 208 Balinese rural respondents to the question "What makes you think person X is mentally ill?" The responses are tabulated by age and sex and a cluster analysis is carried out on them. It is shown that the rural Balinese view interference with others and threatening behaviour as prime indicators of mental illness, but that different indicators are commonly used for women, men, the old and the young. The results are discussed with reference to a sociological model and a medical model of diagnosis.


Circulating antigens, antibodies, and immunoglobulins in the serum of humans with schistosomiasis mansoni.


The toxicology of the phenothiazines.

The toxicology of the phenothiazines.


Metastatic bone tumor.

Metastatic bone tumor.


Thrombosis of the axillary-subclavian vein. A report of two cases.


His bundle recordings in the clinical evaluation of patients with conduction disturbances.


Cardiovascular and physiological aspects of sex. Literature on cardiovascular and pulmonary changes during sexual activity is reviewed and clinically related problems in sexual function are discussed. It is noted that nearly all medical schools in the U.S. now teach human sexual behavior  and factors involved in sexual dysfunction.


Editorial: Turning point.

Editorial: Turning point.


The paradental cyst. A specific inflammatory odontogenic cyst.


Dental education. A report of a working party.


Editorial: Old foes with new faces.

Editorial: Old foes with new faces.


The surgical treatment of bi-maxillary dento-alveolar proclination.


The developing role of dental ancillary personnel.


Intraosseous injections of lignocaine local anaesthetics.


A scavenging system and expiratory valve for use in out-patient dental anaesthesia.


Radiographic artefacts produced by static electricity.


Those mighty old men on their pedal machines.


Co-operation between school dental service and general dental service.


Mandibular growth and dysfunction: a cephalometric and electromyographic analysis of a cross-bite case.


Influence of exogenous tRNA on growth of transplantable 32P-induced osteosarcomata. The weights of osteosarcomata that arose 22 days after the s.c. injection of cell suspensions (of whold tumours) that had been exposed in vitro to tRNA were significantly different from the weights of those arising from untreated cells. The tRNA was isolated by phenol extraction and DEAE-cellulose chromatography from eviscerated full-term rat embryos, from rat mesenchymal (granulation) tissue and from rat anaplastic osteosarcomata. Tumours developing from osteosarcoma cells treated with either embryonic or normal mesenchymal tRNA were reduced in weight by 76% and 60% respectively. These effects could not be explained as a toxic consequence, because tumour weight was increased by 128% after exposure of cells to osteosarcoma tRNA. In this osteosarcoma model it appears that tumour weights can be influenced in different ways by tRNA from different sources.


The lower lip position and incisor overjet.


The retroclined upper incisor.

The retroclined upper incisor.


What use is toothbrushing anyway?

What use is toothbrushing anyway?


The evolution of surgery in the treatment of the unerupted maxillary canine.


Who designs the nation's toothbrushes?

Who designs the nation's toothbrushes?


The development of third molar impaction.


Orthodontic uncertainties.

Orthodontic uncertainties.


Some methods of uprighting lower second molars.


Variations in the soft tissue profile and their relevance to the clinical assessment of skeletal pattern.


Overjet stability after treatment of Class II Division 1 malocclusions.


Upper third molars--an unusual position.


The case for extending basic training in orthodontics.


Continuing orthodontic education for the general dental practitioner.


Two years' basic specialty training in orthodontics: the British prospect in 1975.


Editorial: a need for a greater measure of teaching.


Replanting and transplanting teeth. Part three. Transplantation of teeth other than canines.


Starting from scratch.

Starting from scratch.


The orthodontic study circle.

The orthodontic study circle.


Some methods of uprighting lower second molars--II.


Continuing education for the orthodontist.


The future of orthodontics in the United Kingdom.


Uprighting lower molar teeth.

Uprighting lower molar teeth.


Orthodontics in the undergraduate curriculum--a personal view of doubts and uncertainties.


Attitudes to malocclusion amongst the parents of 10-12 year old children in Glasgow.


Late development of a lower third molar--a case report.


Index for measurement of lower labial segment crowding.


Contour photography.

Contour photography.


The function regulator of Fränkel: Clinical management.


The anomalous mandibular canine.

The anomalous mandibular canine.


The function regulator of Fränkel: The construction of the appliance in the laboratory.


A method for removable orthodontic appliance construction.


The mechanics of plain and looped arches: Part 1.


Orthodontic management of choanal atresia of the newborn.


Periodontal problems associated with the surgical exposure of unerupted teeth.


Editorial: The role of cytogenetics in hematology.


Further characterization of the circulating cell in chronic lymphocytic leukemia. Peripheral lymphocytes from normal individuals and from patients with chronic lymphocytic leukemia (CLL) were cultured in vitro for 1-7 days. The growth response to phytohemagglutinin (PHA) was quantitated by the incorporation of tritiated uridine into RNA nucleotide during a 2-hr pulse with the radioisotope. While the maximum response in PHA-stimulated normal cultures appeared at 2-3 days, CLL cultures required 5-7 days to develop their maximal response, which was 50%-60% of the normal magnitude. Dilution of the number of normally reactive lymphocytes by culturing them with totally unreactive, mitomycin-treated cells produced a normal 72-hr maximal response, no matter what proportion of unreactive cells was included in the PHA-stimulated cultures. In addition, the response of peripheral lymphocytes from patients with myeloblastic leukemia, where large numbers of unreactive myeloblasts diluted the normal small lymphocytes, a depressed reaction occurred at the anticipated 2-3 days. Nylon fiber-adherent lymphocytes consisting of 85% immunoglobulin (Ig)-bearing cells responded minimally to PHA, but showed no evidence of a delay. When isolated from CLL patients, both fiber-adherent cells (Ig-bearing) as well as non-fiber-adherent (sheep erythrocyterosetting) cells responded to PHA in a delayed fashion. Similarly, a case of CLL, in which 93.5% of the circulating lymphocytes bore sheep red blood cell receptors, showed its peak response to PHA at 7 days. Therefore, using surface marker criteria considered characteristic of normal T cells and B cells, the delayed response to PHA on the part of CLL lymphocytes was independent of thymic or nonthymic origin.


A mathematical model of the acute myeloblastic leukemic state in man. A dynamical mathematical model of the acute myeloblastic leukemic state is proposed in which normal neutrophils and their precursors, and leukemic myeloblasts, proliferate as distinct but interacting cell populations. Each population has a Go compartment, consisting of resting cells, that acts as a control center to determine the rate of proliferation. These rates are assumed to depend on the total number of cells in the combined populations. The presence of the leukemic population destabilizes the homeostatic state of the normal population, which is stable in the absence of leukemic cells, and drives the system to a new stable state consisting entirely of leukemic cells and no normal cells. Calculations based on the theory suggest that it is able to simulate the kinetic features of this disease state, at least in its typical manifestations.


Beat the media--know your nutrition facts.


The survey of dental hygiene in Michigan: availability of jobs, salaries and benefits, job security.


Accelerated myeloblast destruction and abnormal lysosome disruption in cultured bone marrow: association with indolent acute myelogenous leukemia. Despite no chemotherapy and a marrow morphologically typical of frank relapse, an acute myelogenous leukemia (AML) patient survived for nearly 1 yr. During this time she remained asymptomatic and maintained nearly normal levels of platelets and hemoglobin. Cytochemical and electron microscopic studies of her bone marrow in liquid culture revealed on several occasions a unique maturational sequence in that leukemic cells differentiated to form morphologically abnormal primary granules which appeared to rupture and cause cytolysis of these cells. In these cultures, blasts rapidly disappeared and were replaced by more mature granulocytes, in contrast to observations in cultures derived from five other patients with AML in relapse which showed persistently elevated blast counts with no evidence of maturation in vitro. These findings support the concept that in AML cell maturation is regularly impaired and in some cases also aberrant. In addition, the abnormal granule formation with autolysis of the leukemic cells observed in one patient may explain both the early cell death in vitro and this patient's relatively indolent clinical course. Similar in vitro studies may help predict atypical clinical courses in patients with AML and facilitate design of appropriate chemotherapy.


In 2026.

In 2026.


QUESTION--Do you agree that continuing education should be one of the requirements for License Renewal?


DNA histogram analysis of human hemopoietic cells. The proliferative activity of human neoplasms may be an important determinant for therapeutic management. The advent of automated flow-through systems measuring cellular DNA content by means of fluorescence has considerably facilitated the analysis of cellular kinetics. Using a pulse cytophotometer ICP-11 (Phywe Co., Göttingen, Germany), three different fluorescent staining techniques for DNA histogram measurement on human hemopoietic cells were tested: mithramycin, ethidium bromide, and a combination of ethidium bromide and mithramycin. Employing the tritiated thymidine labeling index as reference standard for comparison with the DNA histogram-derived S-phase fractions, linear correlations were obtained using ethidium bromide alone and ethidium bromide in combination with mithramycin as staining techniques. The fluorescence intensity was increased fourfold to fivefold by the use of the two-dye combination, resulting in a substantial decrease in the coefficient of variation of DNA histograms to 1.5%-2%. This augmented histogram resolution is an important codition for detecting small-degree numeric chromosomal aberrations and discrete drug perturbation effects.


QUESTION--(February '76)--Is the ADA adequately serving the best interests of the dental profession?


A new and disturbing wrinkle.

A new and disturbing wrinkle.


Dental schools and the ADA.

Dental schools and the ADA.


Editorial: "Communication gap".

Editorial: "Communication gap".


Oral hygiene for orthodontic patients. Current concepts and practical advice.


What's your diagnosis?

What's your diagnosis?


Drugs commonly used in dental practice.

Drugs commonly used in dental practice.


The editor comments.

The editor comments.


Childhood neglect, an adult dilemma.

Childhood neglect, an adult dilemma.


An overview of dentistry in the Peoples Republic of China.


Pennsylvania State Dental Council and Examining Board.


Training of oral hygienists for intraoral injections.


Northeast Regional Board.

Northeast Regional Board.


Dentists can help check hypertension.

Dentists can help check hypertension.


Concerning dental manpower.

Concerning dental manpower.


Inaugural address.

Inaugural address.


A review of vertical dimension.

A review of vertical dimension.


Post delivery care of the edentulous geriatric patient.


The president's message.

The president's message.


Temple dental school renovation to expand clinical facilities.


Food and Drug Administration considers changes in x-ray equipment requirements.


Money and mouths.

Money and mouths.


Health systems agency for southeastern Pennsylvania.


Dental school enrollment.

Dental school enrollment.


Multiple root canals in mandibular incisors: a case report.


A glimpse of health care in the USSR.

A glimpse of health care in the USSR.


Philadelphia shows dramatic drop in decay.


What's your diagnosis?

What's your diagnosis?


Behavior management of the pediatric-adolescent dental patient.


Dental costs continue to decline.

Dental costs continue to decline.


Perspective--1976.


National Cancer Institute finds no evidence to support NHF allegations.


Curiosity can be a killer.

Curiosity can be a killer.


Insurance firms will not pay directly to labs.


New Jersey State Board rules on North American Dental Plan.


The use of precision interlock attachments in full arch ceramo-gold splints.


Arteriography in bone tumours.

Arteriography in bone tumours. The usefulness of arteriography in the diagnosis and management of bone tumours has been evaluated in 78 cases (49 malignant neoplasms, 17 benign tumours and 12 inflammatory lesions). Using well-defined criteria, of which the presence or absence of tumour vessels is of decisive importance, arteriography represents - not as a routine procedure but in selected cases - a most useful guide to establishing the diagnosis, by adding important information to standard radiography, by defining the extent of the lesion and by assisting in the selection of the best site for biopsy.


The multiple sclerotic osteogenic sarcoma of early childhood. Two cases of sclerosing osteogenic sarcoma that occurred in early childhood are reported. They and the similar cases reviewed are unusual in their development at an unusually early age, their multicentric presentation and their densely sclerotic nature. These are uncommon manifestations of osteogenic sarcoma and are considered due to proliferative metastatic osteoid formation in areas of rapid bone growth.


Acupuncture analgesia & therapy in China. Part 2.


Therapeutic irradiation of the central nervous system using intrathecal 90Y--DTA. The erdication of established neuroleukaemia is often difficult, and with subsequent relapses even harder. The use of an intrathecally-injected beta emitting isotope has the advantage of preserving the bone-marrow of the vertebral column and cranium whislt irradiating the meninges. The value of intrathecal 90Y-DTPA(diethylene-triamine penta-acetic acid) has been investigated in nine patients with neuroleukaemia or CNS involvement in malignant lymphoma. Measurements of retention of the isotope in the whole body, spinal, and intracranial subarachnoid spaces have been made, together with blood levels, and are reported. The clinical results are presented. In three out of five evaluable patients 90Y-DTPA failed to maintain a chemotherapy-induced CNS remission and in two out of two evaluable patients malignant cells were not dispersed from the CNS with a single intrathecal injection of 90Y-DTA. It is concluded, therefore, that with this agent and the doses used no useful clinical result is gained.


Familial cancer on a Scottish island.

Familial cancer on a Scottish island. When the causes of death were determined in 18 relations of a child with Fanconi's anaemia 10 deaths were found to be due to carcinoma of various organs. Cases of osteogenic sarcoma, leukaemia, and Marfan's syndrome were also discovered among relatives. The family was from a remote community in the hebrides and there was considerable intermarriage. Suggestive evidence of heterozygosity was found by chromosome analysis.


Editorial: Prognostic factos in childhood leukaemia.


The d. a. on stage.

The d. a. on stage.


Acupuncture analgesia & therapy in China (Conclusion).


Maturity--on and off the job.

Maturity--on and off the job.


Secondary uses of alginate.

Secondary uses of alginate.


What's your diagnosis?

What's your diagnosis?


Patterns or madness. Where is our society going?


An American's heritage: yesterday can teach us how to deal with tomorrow...


--a few thoughts about fees, credit, & collections.


A public image for the dental profession: what creates the public image of a dentist and is there anything you can do about it?


The Western Australian dental therapist--a new member of the dental team.


The future of dental care delivery.

The future of dental care delivery.


Where do we go from here?

Where do we go from here?


Dental school enrollments down.

Dental school enrollments down.


Acupuncture analgesia & therapy in China.


Limited partnership.

Limited partnership.


More than a job. How to satisfy your goals by acknowledging doctor's needs.


Eagle's syndrome.

Eagle's syndrome.


The Chairman of the patient relations committee cogitates.


The d.a. day.

The d.a. day.


Ceruloplasmin levels in sera from human patients with osteosarcoma. Ceruloplasmin (Cp) levels in sera of osteosarcoma patients, women on chemical contraceptives, and normal individuals were determined by radial immuno-diffusion (RID) and rocket electroimmunophoresis (REP) techniques; serum copper levels (SCL) were determined by atomic absorption spectroscopy. Ratios of SCL/Cp were constant in all groups tested, indicating that the ratio of bound to unbound copper in the serum is maintained relative to normal levels both in osteosarcoma patients and in women receiving chemical contraceptives. There was a highly significant increase over normal levels in Cp concentration in sera from patients with osteosarcoma and from women on chemical contraceptives, in agreement with our previous data on SCL. Either RID or REP can be used to measure serum Cp. The latter method appears to be faster and  more sensitive, whereas the former is easier to perform. It appears that the determination of serum Cp in osteosarcoma patients may be of value in differential diagnosis of the disease in selected patients, and in evaluation of the efficacy of therapy.


Inadvertent increase in inspired oxygen concentration due to defect in ventilator bellows.


Fourteen-year remission of acute leukemia in a patient exposed to thorotrast. A case report of a patient who developed acute myelogenous leukemia 15 years after injection of Thorotrast and who has been in a sustained long term remission for 14 years is presented with a review of the problems associated with Thorotrast, subsequently shown to be radioactive with long term sequelae.


The role of irradiation in central nervous system treatment and prophylaxis for acute lymphoblastic leukemia. The results of central nervous system (CNS) treatment with craniocervical irradiation and intrathecal methotrexate in 117 children with ALL achieved at the Joint Center for Radiation Therapy. The Children's Hospital Medical Center, and The Sidney Farber Cancer Center are presented. A classification related to meningeal disease which correlated with prognosis is presented and the patients are analyzed within these groups. Of 80 patients classified in the most favorable groups (I and II), no child has suffered primary CNS relapse. Of the remaining 37 patients in less favorable groups (III, IV, and V), eight patients have experienced CNS relapse, five following or in conjunction with bone marrow relapse. The technical features of irradiation are reviewed and related to success of the treatment.


Prognosis in adult acute myelogenous leukemia related to performance status and other factors. Pretreatment factors of prognostic value were sought in 54 consecutively treated cases of adult acute myelogenous leukemia. Twenty of 37 patients with a good (greater than 50%) pretreatment Karnofsky performance status (P.S.) achieved complete remission (C.R.), while only 1/17 with a poor P.S. achieved C.R. This difference was highly significant (p=0.004). Complete remissions correlated with a median survival of 21 months. Patients with a good P.S. had a median survival of 8 months, while those with a poor P.S. had a median survival of only 1 month. This difference was also highly significant (p less than 0.002). Older patients with a good P.S. did as well as younger patients. The P.S., although imprecise, undoubtedly reflects the extent to which the disease, as well as intercurrent problems, have affected the patient. Attention to this aspect of patient selection for current drug regimens is indicated.


Strontium and fluoride content of surface and inner enamel versus caries prevalence in the Atlantic coast of the United States of America.


Further studies on extracellular glucans synthesized by glucosyltransferases of oral streptococci.


Effect of salivary agglutinins of reactions between hydroxyapatite and a serotype c strain of Streptococcus mutans.


The structure of surface enamel with special reference to occlusal surfaces of primary and permanent teeth.


Variation in caries prevalence related to combinations of dietary and oral hygiene habits in 6-year-old children.


The clinical effect of application of fluoride varnish.


A simplified technique for establishing the vertical dimension and centric relationship in the full denture patient.


Editorial: Dentistry without licensure!

Editorial: Dentistry without licensure!


Shira to fight fragmentation of the profession.


Does lighting affect incidence of dental caries?


Endodontic pitfalls.

Endodontic pitfalls.


Third party pay: will you handle it... or will it handle you?


Deviate swallow and thumb habit management.


Report from China.

Report from China.


Editorial: Ford has an HMO in our future.


Dr. Justen's inaugural address: A world of gloom or brightness?


Letter: The matter of reciprocity.

Letter: The matter of reciprocity.


Editorial: A step toward sanity in malpractice suits.


CDS Emergency Dental Service: Success depends on volunteers.


Psychological aspects of malocclusion.

Psychological aspects of malocclusion.


Editorial: Let's talk it over.

Editorial: Let's talk it over.


Let's take a rational look at myofunctional therapy.


The $1,000,000,000 bonanza--is part of it yours?


CDS review wins again!

CDS review wins again!


Simplified technic for tooth movement.

Simplified technic for tooth movement.


A mouth in the round!

A mouth in the round!


Third party survey discloses local problems.


Guest editorial: The perils of a dental editor.


Component officers air local concerns, study state policies at ISDS conference.


President Pelka's inaugural address: Frankly speaking.


Seymour Yale goes to Iran.

Seymour Yale goes to Iran.


Dental implants--success and failures: An eight-year study.


Letter: To flush or not to flush.

Letter: To flush or not to flush.


Standardized claim forms: A constant third party problem.


Editorial: Your future is being planned.


What I like about the Sargenti method of endodontic therapy.


A psychophysiological study of determinants for detection of deception. Three studies were conducted to obtain available data on the determinants for detection of deception rates. (a) Psychophysiological measures were evaluated for effectiveness in detecting deception. A relevant-irrelevant method was used with two conditions; neutral stimulus and personal stimulus. Of the physiological variables, skin potential response, skin resistance response, finger pulse volume, and skin blood flow were significant indicators of deception. (b) Three experiments were conducted to study the psychophysiological effects of false and true feedback of skin potential response on the detection rates. It was concluded that the subjects receiving information that they were detectable were easier to detect than the subjects who believed that they were not detected and the subjects who received feedback of actual responses. (c) With the use of skin potential response channel, significant detection rates were obtained for all experiments under the condition that subjects verbally lied by means of "No" responses. On the other hand, the subjects who were motivated to deceive produced differentially augmented responses in the absence of any verbal response and also when the subjects told the truth to critical items and lied to irrelevant ones.


Dextran degrading bacteria in human oral cavity and their activity against insoluble glucan from Streptococcus mutants. The distribution of dextran-degrading microorganisms in the saliva and plaque samples from the human oral cavity was assayed on 9 subjects. Approximately 2/3 of the saliva samples degraded Dextran T-150 (Pharmacia, M.W. 150,000) and 1/10 the Blue Dextran (Pharmacia), while 2/5 and 1/8 of the plaque samples degraded Dextran T-150 and Blue Dextran, respectively. Thirty-seven strains of the Blue Dextran degrading bacteria were isolated from the saliva and plaque samples and were classified into 6 groups by their morphology, gram staining and oxygen tolerance. The 24 strains from the 37 isolates, more or less, were shown to degrade the insoluble glucan extracted from Streptococcus mutans FA-1 on the agar plate. The 8 strains, selected from each group, were tested for their activity against the insoluble glucan extracted from Str. mutans (FA-1, HS-6, BHT, CHT, GS-5, LM-7 and PK-1) and Str. salivarius (HHT). The strains belonging to Groups I, II, IV and V showed activity against the insoluble glucan used. Among them, the strains of Group IV (gram negative facultative cocci) and Group V (gram negative strict anaerobic rod) were the most active against the insoluble glucan.


Dextran degrading activity of oral microbial flora. Dextran degrading activity of the human oral microflora was detected by culturing in TYD broth (Tryptose 1.0%, Yeast extract 0.3%, Dextran T-150 (Pharmacia, MW 150,000) 0.15%). All of the plaue and saliva samples collected from 10 subjects showed a dextran degrading activity, both cultured aerobically and anaerobically, while the anaerobic culture was more active than the aerobic. Furthermore, some individual differences were observed in their activity. Crude enzyme(s) was extracted from the supernatant of a mixed culture of plaque sample by adding ammonium-sulfate to 0.6 and 0.8 saturation (called E-1 and E-2, respectively). E-1 contained 2 dextran-degrading enzymes, one being thought to be an endo-enzyme, with the optimal of H being 5.0 and the other an exo-enzyme with the optimal pH being 7.0-7.5. On the other hand, E-2 contained 1 enzyme of the endo-type. Thirteen strains producing dextranase were isolated from the plaque and were identified as Bacteroides oralis-like organisms. Several other organisms were thought to produce dextranase, although we failed to isolate them in this experiment.


Precipitation hardening in gold-cobalt alloys. The precipitation hardening in gold-cobalt alloys containing less than 5 wt.%Co was studied by means of resistivity, hardness, X-ray diffraction, and optical microscopic examination. The hardness curves showed two hardness peaks after isothermal ageing below the temperature of 250 or 300 degrees C. It was considered that the first peak was due to the formation of G.P. zone which was confirmed by reversion phenomenon. The second peak was due to the growth of metastable cobalt-rich precipitate, and this stage was found to make a major contribution to the age-hardening in the present alloys. The nodular products at grain boundary do not play an important role in age-hardening. Acitvation energies, order of the reaction involved, and the rate constant for the growth process were established. The difference in growth mechanism of the metastable precipitate was deduced from the kinetics data.


Gingival architectural forms in periodontal diseases. Changes in the gingival architectural form and the incidence were observed on 1,700 interdental papillae and 3,791 parts of the gingival margin of 89 patients, both males and females, with periodontal diseases. The effects of improperly adapted restoration, tooth irregularity, depth of periodontal pocket and degree of bone loss on the gingival changes were also examined. Of the four types of changes observed in the marginal gingiva, the recessed form occurred most frequently. Next in order of frequency of occurrence were the ledged, festoon and cleft forms. The greater part of the gingival changes observed in the interdental papilla were both of the blunted and enlarged forms. In the interdental papilla, the blunted and cratered forms increased and the enlarged form decreased according to the degree of bone loss. Improperly adapted restoration and tooth irregularity influenced the gingival changes observed. The depth of the periodontal pocket was not found to influence the gingival form.


Esthetics for tetracycline stained teeth.


Valium: an oral cleft teratogen?

Valium: an oral cleft teratogen?


Editorial: Closer liason with professional persons concerned with craniofacial anomalies throughout the world.


Facial and dental relationships of individuals with unoperated clefts of the lip and/or palate. Twelve individuals with unoperated unilateral clefts of the lip and palate and eight with unoperated unilateral clefts of thelip and alveolus were examined clinically and cephalometrically. The two groups were compared to each other and to a matched sample of normal individuals. All subjects were examined in their native India. Based on the findings of this investigation, it is suggested that, in general, the cranial base and skeletal face are not extensively malrelated in individuals with either unoperated unilateral clefts of the lip and palate or of the lip and alveolus when compared to matched normals. Yet, there are distinct differences in dentoalveolar and skeletal relations between both cleft groups and normals and between the two cleft groups.


Treatment principles for the changing arch form in children with complete unilateral cleft lips and palates. Data on maxillary growth for 62 normal and 87 complete unilateral cleft lip and palate subjects presented in 1975 is supplemented and extended. The children ranged in age from six months to four years and were evaluated at four developmental stages. In order to clarify the character of the maxillary arch deformity, measurements of depth, width, height, and length were made and analyzed statistically. Prior to lip repair, cleft and normal subjects showed similar patterns of maxillary growth. This similarity was not apparent by age two. Anterior-posterior growth inhibition of the maxilla appeared to occur after lip repair and to remain a problem by age four. The authors discuss possible ways of minimizing these differences by management techniques.


Craniofacial growth in complete unilateral cleft lip and palate: a roentgeno-cephalometric study. This study investigated craniofacial growth in unilateral complete clefts using lateral roentgenographic cephalograms. The cleft sample was composed of 135 males and 120 females aged four, six, eight, ten, twelve and eighteen years. Control subjects included 120 non-cleft males and 120 non-cleft females of similar age to the cleft subjects. The cleft group differed from the control group in several major respects: (1) Their over-all growth trend showed a more downward or vertical direction; (2) The cranial base angle was more flattened; (3) The maxilla was smaller and was located in a more posterior and upward position; (4) Ramal height was shorter and the gonial angle was more obtuse. Chin position was generally retrognathic; (5) Skeletal profile showed less convexity; (6) Upper face height was less and lower face height was greater; (7) Both upper and lower central incisors showed a marked lingual inclination; (8) Females in both groups matured about two years earlier than did males. Underdevelopment in both the maxilla and the mandible was more pronounced in cleft females than in cleft males.


Morphological findings in unoperated cleft lips and palates. A total of 353 children with cleft lips and palates were examined with regard to the morphology of the tissue surrounding the clefts in the lip, jaw, and palate. Photographs, radiograms (panoramic views of the maxilla), and study models were taken prior to operation. Results indicate a close relationship between the degree and condition of the cleft and the extension of the vermilion, the number of tooth buds adjacent to the cleft, the form and size of the alveolar borders, and the number and type of incisors. In isolated cleft palates, the cleft edges are always symmetrical and there is a gradual transition from board-arched, total clefts of the hard palate to the bifid uvula having no impact on articulation.


Clinical conference I. Calvarium and cranial base in Apert's syndrome: an autopsy report. A post-mortem examination of a 22-month-old boy with Apert's syndrome is reported. A linear coronal craniectomy performed at 11 months of age had fused completely in spite of the insertion of polyethylene film between the bony edges. Furthermore, progressive synostosis of other cranial sutures was observed. Histological examination of the cranial base showed that the sphenofrontal suture was fused and that the entire cerebral surface, including the sella turcica, was characterized by bone resorption. The sphenooccipital synchondrosis was extremely wide and abnormally shaped, and the chondral growth activity seemed diminished. It was concluded that the patient exhibited primary as well as secondary growth distrubances in the calvarium and cranial base. The premature synostosis of the coronal and sphenofrontal sutures and the anomaly of the sphenooccipital synchondrosis were interpreted as primary defects. The altered shape of the calvarium and the marked resorption and shortening of the cranial base were considered secondary changes. Furthermore, the investigation indicated that the conventional linear coronal craniectomy cannot be expected to improve the craniofacial growth pattern in patients with Apert syndrome. Alternative surgical procedures were suggested.


Nasal deformity in unilateral cleft lip. The author presents his experience with the primary correction of nasal deformity in unilateral cleft lips in twenty five cases ranging in age from five months to 30 years. Emphasis is placed upon the important anatomical characteristics of the deformity, i.e. attenuation of the alar cartilage, displacement of the medial crus, thickening of the alar base as the result of deposition of fibrofatty tissue between the two separated layers of skin, accumulation of fibrofatty tissue between the two separated alar domes, drooping of the involved nostril and the presence of a well marked alar arch web. The technique described includes an adequate exposure through a bilateral gingivolabial sulcus incision connected by an intercartilaginous incision, release of the displaced alar base and columella, freeing of the alar cartilage from the opposite side and from overlying skin, repositioning of the alar cartilage and alar dome to a normal anatiomical position, and maintenance by a through and through mattress suture and a post-operative nasal pack. The immediate results have been satisfactory.


beta-Bungarotoxin, a phospholipase that stimulates transmitter release.


Electrogenic effects of neutral amino acids on neurons of Aplysia californica.


Preservation of synaptic structure by rapid freezing.


The number of acetylcholine molecules in a quantum and the interaction between quanta at the subsynaptic membrane of the skeletal neuromuscular synapse. 1. Postsynaptic responses to acetylcholine released from nerve terminals and from iontophoretic micropipettes were investigated in skeletal twitch-muscle fibers of the snake. The preparation consists of thin sheets of muscle fibers in which details of the end plate, including the outlines of individual synaptic boutons, are clearly seen in the living state. After treatment with collagenase, the motor nerve and its terminal boutons can be removed to expose the intact subsynaptic membrane to direct application of ACh by iontophoretic pipettes. 2. The number of ACh molecules in a quanta was estimated to be fewer than 10,000. This was done by developing a sensitive bioassay to measure the output of ACh from iontophoretic pipettes needed to produce synaptic responses closely resembling nerve-released miniature postsynaptic potentials. 3. Postsynaptic receptors are not saturated by the ACh in a quantum, since the peak of the quantal response produced by an appropriate background concentration of ACh from a pipette. 4. When acetylcholine esterase is inhibited, two or more quanta can act upon partially overlapping postsynaptic membrane areas and potentiate each other's effects. This potentiation reveals itself as a prolongation of the synaptic current. Postsynaptic potentiation is a consequence of the nonlinear dose-response characteristics of ACh receptors and can also be demonstrated in a model system in which ACh micropipettes substitute for quantal release from the nerve. 5. With AChE fully active, however, each quantum is functionally isolated from its neighbors and no postsynaptic potentiation is seen. 6. It is suggested that postsynaptic potentiation between quantum may play a role in signaling at synapses which have nonlinear dose-response characteristics and where transmitter is not so rapidly inactivated as at the neuromuscular synapse.


Characterization of Torpedo californica acetylcholine receptor: its subunit composition and ligand-binding properties.


On the interaction between cobra alpha-neurotoxin and the acetylcholine receptor.


The biochemical properties and regulation of acetylcholine receptors in normal and denervated muscle.


Turnover of acetylcholine receptors in skeletal muscle.


Control of ACh sensitivity in rat muscle fibers.


Persistence of junctional acetylcholine receptors following denervation. The relative number of acetylcholine receptors at normal and denervated end plates in rat soleus muscles was studied using the binding of 125I-alpha-bungarotoxin as a quantitative assay. After short-term denervation (up to 2.4 weeks), the extrajunctional binding increased, but there was no change in specific binding to the motor end plate. Denervation for longer periods (up to 7 weeks) reduced binding sites at the end plate by as much as 60-70%. Direct electrical stimulation of these muscles for the entire period of denervation did not prevent the slow loss of junctional binding sites, even though it was adequate to abolish the increase in extrajunctional binding. Cross-innervation by a foreign nerve at a site distant from the original end plates was more effective than stimulation in preserving the old end plates; in cross-innervated muscles, many denervated end plates continued to bind normal amounts of toxin for over 4 months. In comparison with the rapid rate of appearance or disappearance of extrajunctional ACh receptors, however, the number of junctional receptors at all denervated end plates was quite stable, suggesting that the persistence of these receptors is not immediately dependent on the presence of a motor nerve terminal.


Properties of the sodium channel gating current.


The formation of neuromuscular synapses.


Anatomy and development of identified cells in isogenic organisms.


Biochemical studies on the development of primary sympathetic neurons in cell culture.


Physiological properties of nerve-muscle junctions developing in vivo.


Formation and elimination of synapses in skeletal muscles of rat.


Cell junctions in development, with particular reference to the neural tube.


Permeable junctions.

Permeable junctions.


Responses of spinal motor neurons to section and restoration of peripheral motor connections.


The protein components of the gap junction.


Repair of specific neuronal pathways in the leech.


Topographic polarity of the optic tectum studied by reimplantation of the tectal tissue in adult goldfish.


Ultrastructural analysis of functional changes in the synaptic endings of turtle cone cells.


Adaptive synaptic connections formed in the visual pathways in response to congenitally aberrant inputs.


Synaptic competition in the kitten's visual cortex.


Pepherial feedback in the leech swimming rhythm.


Analyzing natural images: a computational theory of texture vision.


Differential labeling of glial cells and GABA-inhibitory interneurons and nerve terminals following the microinjection of (beta-3H)alanine, (3H)DABA and (3H)GABA into single folia of the cerebellum.


X-chromosome inactivation and selection in somatic cells. X-Chromosome inactivation leads to the formation of mosaic cell populations in the somatic cells of mammalian females. Cells have either a maternal or paternal X-chromosome active. If an individual is heterozygous for a cell autonomous X-linked trait, then a set of built-in cellular markers is provided for the investigation of various developmental phenomena, including selection. In the absence of somatic cell selection the tissues of an X-linked heterozygote should all be mosaic and should have a mosaic composition approaching 1:1. If somatic cell selection is occurring, it should be detectable by a significance shift from the random expected 1:1 mosaicism. The system is effective at detecting selection acting on X-linked loci and on newly arisen somatic autosomal variants, and several examples of somatic cell selection are described. However, it is concluded that somatic cell selection, as described above, is not a normal aspect of ontogeny.


Asbestos exposure control at Puget Sound Naval Shipyard.


Editorial: True continuing education.

Editorial: True continuing education.


Myofunctional therapy.

Myofunctional therapy.


Letter: Academy should discourage news media from evaluating dental techniques.


Blood pressure: your easiest and most important tool.


Blastic crisis in previously clinically silent chronic myelogenous leukemia. A patient is described in whom CML first presented as blastic crisis. The diagnosis of CML was based upon the findings of Ph(1) chromosome in the bone marrow, basophilia in the peripheral blood, absence of NAP activity in the leukocytes, elevated serum vitamin B(12) and an enlarged firm spleen. CML with blastic crisis as its first expression is relatively rare, as compared to CML in which blastic crisis appears as a phase of prolonged clinically manifest disease.


Oral ulcerations and their management.

Oral ulcerations and their management.


In vitro differentiation of Rauscher-virus-induced myeloid leukemia cells. Three cell lines were established in vitro from myeloid leukemias of C57Bl/6 strain mice which had been inoculated with Rauscher virus at birth. The use of heated conditioned medium from peritoneum proved helpful for the initial growth of leukemic cells. At early in vitro passage levels, cell line R433 differentiated only to macrophages after contact with conditioned medium from peritoneum but it appeared to have lost the ability to differentiate during an extended period of cultivation. Cell line R448 was cytologically promyelocyte. When exposed to conditioned medium, this cell line differentiated only to neutrophilic granulocytes. Cell line R453 maintained the ability to differentiate either to neutrophilic granylocytes or to macrophages. Single cells recloned three times still gave rise to both types of mature cells containing conditioned medium. Occasional cases of "spontaneous" differentiation in clonal lines of R453 also occurred.


Non-random karyotypic evolution in chronic myeloid leukemia. The chromosome banding pattern was analyzed in bone-marrow cells and/or spleen cells of 10 patients in the blastic phase of chronic myeloid leukemia (CML). It was obvious from the karyotype analysis that the chromosome aberrations occurring addition to the Philadelphia chromosome (Ph1) were strictly non-random. An extra Ph1, trisomy 8 and/or trisomy for the long arm of chromosome 17 were observed in all cases. This consistent pattern of chromosome involvement in CML was confirmed in 57 cases from the literature studied with banding techniques. In 88% of the total number of cases with further changes at least one of the three main chromosomal aberrations was found ("major route" of karyotypic evolution).


Non-random chromosome changes in acute myeloid leukemia. Chromosome banding examination of 30 cases at diagnosis. Bone-marrow chromosomes were examined with the G-banding technique in 30 patients with acute myeloid leukemia at the time of diagnosis. In 13 of the 30 patients (43%) only normal diploid bone-marrow cells were found, and no deviations from the normal banding pattern could be detected in these cells. In bone-marrow cells of 17 patients (57%), distinct chromosome abnormalities were found; in 10 of the patients only abnormal cells were observed, whereas in 7 of the patients the abnormal cells coexisted with normal diploid cells without any visible chromosome banding abnormality. The results of the detailed analysis of the karyotypic aberrations demonstrated that when chromosome aberrations occurred they were clearly non-random. All patients except two displayed trisomy 8,9 or 21 or monosomy 7. Analysis of cases of acute leukemia from other laboratories indicated that the same consistent pattern of chromosome involvement prevailed in them.


Letter: Dentist calls AGD compromise with U.S. administrators "unacceptable".


Letter: Getting away from mediocrity.

Letter: Getting away from mediocrity.


A dying patient: the question of euthanasia. Mrs. A. B., a 61-year-old woman who presented with carcinoma of the breast in 1964, was readmitted to the hospital in 1974 in respiratory distress ensuing from chronic lung disease and metastatic illness. An active member of Alcoholics Anonymous for the past sixteen years, she had a living pattern in which she felt in control of herself, and from which she derived an important sense of self-esteem. Although in the hospital she requested that no extraordinary measures be taken to prolong her life, when she went into respiratory failure the house staff on duty intubated her and placed her in the Intensive Care Unit. Even though her physical condition rapidly improved, the patient told her own physician that she wanted to be extubated and off Intensive Care, despite her knowledge of a probable short survival. When her request was agreed to, contrary to expectations, she continued to improve. A lawyer, interested in problems of dying and euthanasia, interviewed her, and subsequently Psychosocial Rounds were held. The general conclusions at the Rounds were that she would die an appropriate death, and that euthanasia would not be possible under current circumstances. The staff at the Conference decided to accept at face value her request that she be allowed to die without heroic measures and with dignity.


Crisis facing private dental practice.

Crisis facing private dental practice.


Group process: an adjunct in liaison consultation psychiatry. Many liaison psychiatrists have advocated staff meetings as a means of enhancing communications on a medical ward. This paper, based on a one year experience as a psychiatric consultant to a medical ward in a major teaching institution, describes the implementation of a weekly group meeting of nursing and social service staff as a component in the structure of an effective liaison service. Case material is presented to document the efficacy of group process as a teaching and therapeutic modality. By encouraging the verbalization of cogent feelings and anxieties in a weekly group meeting, members developed a sense of mutual trust and openness. In an atmosphere conducive to promoting clarification, understanding, and insight, the group members increased their self awareness of the psychological aspects of physical disease and the effect of their own emotions on the interpersonal process of patient care.


A "desperation-reaction" model of medical diffusion. Knowledge about the adoption and diffusion of innovations is briefly reviewed. A model is then proposed to explain how certain innovations, intended to address dire medical problems, might diffuse in a manner not previously reported, with extensive diffusion occurring during what would be a period of small-scale experimentation and limited adoption in the conventional innovation-diffusion environment. The model is illustrated with findings from a case study of the diffusion of drug therapies for four types of leukemia. Possible implications of "desperation-reaction" diffusion are suggested.


Editorial: New look.

Editorial: New look.


Letter: No fingerprints? Try bite marks!


Cementing pins with cyanoacrylate (an appraisal of biodegradability).


Acute lymphoblastic leukaemia after treatment of nephrotic syndrome with immunosuppressive drugs. The authors present a 4-year-old girl with nephrotic syndrome who developed actue lymphoblastic leukaemia 5 months after the start of a combined treatment of alternate day prednisone and daily cyclophosphamide during 3 months. The nephrotic syndrome was due to focal segmental glomerulosclerosis. The occurrence of leukaemia might be related to the preceeding treatment with cyclophosphamide.


Letter: Who's got the dollar?

Letter: Who's got the dollar?


Editorial: Adam's rib: essays on biblical medicine.


Clustering of aberrations to specific chromosomes in human neoplasms. II. A survey of 287 neoplasms.


Consciousness: an added dimension in the treatment of cancer.


Editorial: Family dentist?

Editorial: Family dentist?


The state of dental health and oral hygiene in Sierra Leone.


Letter: Board recognition for the dental "generalist".


Editorial: Journal changes.

Editorial: Journal changes.


Stigmata--passion and punishment a modern case history.


PSI and the life cycle.

PSI and the life cycle.


Letter: Insurance carriers should not judge dentists' competence.


Letter: Is the grass-roots member's voice heard?


The relationship of nutrition to psychosomatic disorders.


Avocational therapy in psychosomatic disorders.


An electromagnetic theory of acupuncture.


The accumulation of bioelectrical energy.


Review of some ESP experiments with a hypnotically prepared subject.


The autogravity hypothesis as a possible explanation for psychokinetic phenomena.


Characterization of glass-ionomer cements. 1. Long term hardness and compressive strength.


Stress relaxation studies on dental materials. 1. Dental cements.


The effect of complete dentures on the development of speech articulation in children.


Editorial: Editor of the Journal of Dental Education.


Finger-manipulated and floss-holder flossing: a comparison of the habit formation.


Dental education's responsibility for oral health status in the United States.


Letter: Comments on AADS consultation service.


The association of academic health centers.


An investigation of behavior change in continuing dental education.


The teaching of pharmacology in dental schools in the United States and Canada. The teaching of pharmacology in dental schools in the United States and Canada was studied through an analysis of information provided by course directors of 58 schools. The study focuses on the number of courses taught and their position in the curriculum, the faculty and their professional qualifications, the length and content of courses, the textbooks used, methods of teaching, and examinations and other criteria for grading.


Designing and implementing relevant courses in dental management. 1. Dentist managerial behavior as defined by the dimensions described here is significantly related to dental team effectiveness. 2. Dental management courses and clinical experiences should be based, at least in part, on these dimensions of dentist managerial behavior.


Faculty evaluation: a tool for eliciting desired behaviors.